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General NPI Number Information
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NPI Number | 1952622482
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Entity Type | Organization
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Legal Business Name | GOMEZ FAMILY CARE,INC
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 2535 NW NORTH RIVER DR
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City | MIAMI
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State | FL
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Zip | 33125-1243
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Country | US
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Telephone | 305-400-8572
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Fax | 305-400-8573
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Provider Business Mailing Address
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Address Line | 2535 NW NORTH RIVER DR
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City | MIAMI
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State | FL
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Zip | 33125-1243
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Country | US
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Telephone | 305-400-8572
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Fax | 305-400-8573
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Authorized Official
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Title or Position | ADM
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Name | MR. RICARDO GOMEZ
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Credential | OWNER
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Telephone | 305-728-1141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL11781
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License Number State | FL
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